Gastroenterology/ Hepatology Flashcards
Name some causes of unconjugated jaundice?
Physiological jaundice
Breast milk jaundice
Haemolytic disease (rhesus incompatibility or ABO incompatibility)
G6PD deficiency
Gilbert Syndrome
Name some causes of conjugated jaundice?
Neonatal hepatitis
Biliary atresia
Aligille Syndrome
Alpha-1-antitrypsin deficiency
HBsAg positive + HBeAg positive =
High risk (requires Hep B vaccination and IVIg)
HBsAg positive + HBeAg negative
Low risk (requires Hep B vaccination only)
HBsAg positive + e antibody positive =
Low risk (requires Hep B vaccination only)
HBsAg positive + no ‘e’ antibody/ antigen =
Intermediate risk (requires Hep B vaccination and IVIg)
Explain the clinical findings of conjugated bilirubinaemia?
Dark urine
Pale stools
Pruritis
A caucasian child with Coomb’s negative haemolytic anaemia and splenomegaly, consider?
Hereditary Spherocytosis
What are the blood results in Wilson’s disease?
Reduced total serum copper levels
Reduced caeruloplasmin levels
Increased urinary copper excretion
What is the treatment of Wilson’s disease?
Penicillamine
Pyridoxine
Symptoms of zinc deficiency?
Periorofacial dermatitis
Diarrhoea
Growth failure
Immunodeficiency
Symptoms of copper deficiency?
Anaemia
Neutropenia
Osteoporosis
Soft tissue calcification
Symptoms of selenium deficiency?
Cardiomyopathy
Skeletal aches and pains
Pseudoalbinism
Symptoms of vitamin A deficiency?
Night blindness
Follicular Hyperplasia
Poor growth
Impaired resistance to infection
Symptoms of vitamin E deficiency?
Peripheral neuropathy
Retinitis pigmentosa
Ataxia
What are the fat soluble vitamins?
A, D, E, K
Symptoms of folate deficiency?
Microcytic anaemia
Chronic diarrhoea
Poor growth
Thrombocytopenia
Irritability
Which foods is folate found in?
Green vegetables
Yeast
Milk
Which group of individuals are most at risk of vitamin B12 deficiency?
Vegans
Symptoms of Vitamin B12 deficiency?
Anaemia
Glossitis
Peripheral Neuropathy
Which agents are used in the induction and maintenance of remission in patients with Crohn’s disease?
Polymeric Diet - induction of remission
Thiopurines (e.g. azothioprine) - maintenance of remission in patients without perianal disease (methotrexate can be used as an alternative)
Infliximab - maintenance of remission in patients with perianal disease
What is the management plan for a mother with HIV and a viral load of <50 copies at 36 weeks?
Low risk delivery
Vaginal delivery
Zidovudine therapy for 4 weeks (mono therapy)
What is the management plan for a mother with HIV and a detectable viral load? (>400 copies)
Planned C-section
Triple therapy for 4 weeks
What is the feeding advice for mothers with HIV?
Formula feeding (regardless of viral load or HIV prophylaxis treatment)
List the possible causes of Chorioform movements?
Sydenhams Chorea - up to 6 months after rheumatic fever
Huntington’s Disease
Kernicterus, Wilson’s disease, Thyrotoxicosis
Benign Familial
SLE
Drugs e.g. metoclopromide/ dopamine
